The literature described so far regarded institutionalized medical dominance, whatever its basis, as the key factor in the general trend of medicalisation. The medical profession’s monopolistic control of specialized medical knowledge and skills; its nurturing of dependency on medicine amongst the lay population; and its expanding ability to define areas of abnormality as amenable to medical intervention, were alleged to be bringing about this major shift in social control. Such views generally implied, tacitly or explicitly, that medicalisation was not in patients’ interests, a position informed by the contemporaneous questioning of the effectiveness of interventionist medicine then emerging; for example, that associated with McKeown (1976). However, even in the 1970s, there were medical sociologists, (most notably (Fox, 1977; Strong, 1979), who suggested that some accounts of ‘medical imperialism’, were exaggerated. More recently, this questioning has increased and some of the original proponents of the
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